Personality Disorders

Personality Disorders

Personality disorders involve patterns of thought, behaviors, and perceptions about the world that can make everyday life difficult. If you have a personality disorder, your relationships are volatile, holding a job is difficult. Everyone else is wrongand you're right; you are rigid and inflexible in your thinking. There are many types of personality disordersand they are believed to develop from early childhood events. Counseling and medications can help.

The course of this illness is variable and often prolonged. It is more common in women, and usually surfaces during the teen years or young adulthood, with the first serious symptoms often appearing at the time of a significant change or separation. All people with this disorder experience upheaval, chaos and pain. Sometimes the illness can be managed with outpatient treatment. Some people require periodic brief hospitalizations when symptoms are intense. Other people require longer inpatient treatment to provide safety while they are learning healthier patterns of behavior. Most people make a reasonable work and social adjustment.

Borderline personality disorder is a psychiatric disorder that includes problems with intense mood instability, severe difficulties in interpersonal relationships, problems with behavioral control, including suicidal behaviors, and often a disrupted cognitive process during periods of high stress. Symptoms include:

Frantic efforts to avoid real or imagined abandonment

A pattern of unstable and intense interpersonal relationships characterized by alternating extremes of idealization and devaluation

Treatment of narcissistic personality disorder usually consists of individual, group or family therapy, structure (scheduling one's time so there are no long periods of unplanned time), support, medications for specific symptoms, limit-setting, consistent rules, education about the illness, social skills training, behavior modification and learning more effective communication and coping skills. Inpatient or day hospitalization may be necessary when symptoms make the patient a danger to self or others.

Narcissistic personality disorder is part of the Cluster B group of personality disorders in the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders, version 5, of the American Psychiatric Association). This group is characterized by dramatic, erratic, and overly emotional behavior and thinking. People with this disorder believe themselves superior to others and often exaggerate their own value and importance. They have a need for admiration and disregard the feelings and emotions of others. They feel they should be praised, should never have to wait, and have fantasies about success and achievement. They are sensitive to failure, criticism, and defeat, which often enrages or depresses them. Others often find them offensive, self-centered, and arrogant.

Paranoid personality disorder is part of the Cluster A group of personality disorders. This group is characterized by eccentric or odd behavior and thinking. People with this disorder harbor suspicion or mistrust of others with little or no valid reason. They fear others intend to harm them and that there are malicious and harmful motives behind the actions of others. They may feel alienated, isolated, and emotionally detached from others.

The cause is unknown at this time, but several theories are being looked at. There is some evidence that inheritance and other biological or biochemical factors may be involved in some people. Psychological factors are also involved for most people. For example, having had childhood trauma (physical, sexual, or emotional abuse or neglect, or prolonged separation) is far more common in people with this disorder than in the general population.

Paranoia is a pervasive, unfounded and/or exaggerated distrust of others and their motives. People who have a long-term pattern of paranoia (but who have not been diagnosed with possible causes such as schizophrenia or Alzheimer's disease) may be diagnosed with paranoid personality disorder. Symptoms of paranoid personality disorder include:

an unjustified belief that others are trying to harm or deceive you

an unjustified belief that others are disloyal, unfaithful or untrustworthy

a suspicion of others that may lead to social isolation

perception of innocent remarks as insults or attacks

inability to work well with others

hostility and anger

tendency to hold grudges

Someone who has been diagnosed with paranoid personality disorder may be helped through treatment with psychotherapy (or "talk") therapy and medication.

A person with a neurotic personality exhibits characteristics of excessive worry and anxiety over normal life events. Symptoms of a neurotic personality may include:

depression

unrealistic fears

obsessions

repetitive, compulsive behaviors

irritability

feeling tense

low self-esteem

Neuroticism can occur on a continuum. Some experts speculate that being mildly neurotic may actually have some health benefits by causing people to think twice about engaging in risky or potentially unhealthy behavior. On the other hand, people with high neuroticism are known to be more likely to smoke, drink, use drugs, and engage in unsafe sex. If the symptoms and traits associated with having a neurotic personality begin to interfere with normal, everyday functioning, treatment -- including therapy/counseling and possibly anti-anxiety medicines -- may be recommended.

Bipolar is an episodic mood disorder. When a person is not a mood swing such as mania or depression, the symptoms are not present. BPD is a pervasive illness that is considered a part of a person’s personality. It is not episodic.Definition of BPD People with BPD often feel misunderstood, alone, empty and hopeless. They're typically full of self-hate and self-loathing. They may be fully aware that their behavior is destructive, but feel unable to change it. Poor impulse control may lead to problems with gambling, driving or even the law. They may find that many areas of their lives are affected, including social relationships, work or school. Those with the illness often show strong changes in moods, but these often seem calculated as they can be turned off and on. (Mayo Clinic, 2011)Sheila: “I feel that I’m reeled in by my husband's charm and then punched in the face (not literally, but definitely emotionally). His charisma is often so amazing. No one believed me it was happening, people would say he was a great guy, but it seems he only saved it for me behind closed doors." And yet, those with the illness are in great pain and are not simply acting out. It’s a true illness.How is Bipolar Different? Bipolar mood swings sit on top of a person and are not part of their personality. The mania, depression and anxiety start and end at a specific time. It’s a very serious illness and like BPD can cause great disruption in family, work and financial relationships, but it does come and go.Treatment Bipolar is treated with medications such and a strong management plan. The treatment outcome for BPD is complicated as the drugs on the market address only some of the symptoms such as depression and anxiety, but there is no specific drug for the illness.What is Dialectical Behavioral Therapy? (DBT) Many of those with BPD have had great success with DBP. There are many books on the topic of DBT as well as therapists and centers that specialize in the therapy. DBT is for family members as well.Can a Person Have a Bipolar and BPD Diagnosis? Yes! If you or your loved one has both, make sure you work with a health care professional who understands how they interact. There is hope for the treatment of both illnesses.